Very few Montanans voluntarily go without health insurance, according to a survey conducted by the University of Montana Bureau of Business and Economic Research. This suggests that many uninsured will participate in the health insurance exchanges created as part of the Affordable Care Act, said Paul Polzin, interim director of BBER’s health care industry research program.

The survey found that 76 percent of the uninsured in Montana are involuntarily uninsured. Reasons for lack of health insurance varied, but many respondents noted low-wage jobs, premiums that were too expensive or forced unemployment, Polzin said.

The Affordable Care Act is scheduled to take effect on Jan. 1 and will provide health insurance to many of Montana’s uninsured, Polzin said. However, there are many uncertainties concerning how it will turn out.

BBER’s survey found that about 20 percent of Montanans — about 195,000 people — were uninsured. This figure is similar to what the U.S Census Bureau reports.

The uninsured have poorer health than the insured.

“Almost 50 percent of the survey respondents who said they have fair or poor health were uninsured,” Polzin said. “The reasons for their poorer health are not known for certain. Some experts believe that uninsured peoples’ health may improve once they have better access to health care.”

Additionally, the uninsured have more medical debt, Polzin said. About 23 percent of the uninsured said they had medical debts as compared to about 9 percent of the insured.

The survey also found a surprisingly low level of knowledge among those with insurance about important features of their coverage.

“Consumer knowledge is important for rational decision making, and this ignorance may be one of the factors plaguing the health care sector,” Polzin said.

The survey was conducted by telephone — including cell phones — from Sept. 12, 2012, to Feb. 27, 2013. There were 4,662 completed interviews.